医療コミュニケーションとしてのインフォームド・コンセント : 討議倫理学の立場から

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  • Informed Consent as Communication in Medical Care : Discourse Ethics Approach

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It is the purpose of this paper to argue the possibility of the application of discourse ethics (Diskursethik) to informed consent in bio-medical ethics. Discourse ethics, in general, is conceived as intersubjective acknowledgement of the validity-claims in acts of linguistic communication. The great progress in medical techniques is transforming the problems of substantial justification, i. e. grammar of life-form. Biomedical ethics also should take this current of time into consideration. The concept of informed consent forms important part of self-determination in medical care. It consists of the autonomy of the patient. And autonomy or self-detemination in medical care makes conditions for the patient's own intention, understanding and non-controlled. Self-determination in medical care contains the resistance to the abuse of paternalism in medical care and bio-medical experiments. But it is necessary in medical care,as many authors have pointed out,to balance self-determination, nonmaleficience and beneficience. Then what are these concepts founded on ? From the discourse ethics's view, self-determination (autonomy) and beneficience in informed consent adhere in dialogical communication as the validity-claims in acts of linguistic communication. The validity-claims are explicated through speech-act theory or pragmatics. Discourse ethics was proposed by J. Habermas about thirty years ago, but it seems there are few application studies. We are expecting more studies about the application of discourse ethics to medical care.

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